Abstract
<h3>Purpose</h3> Antifibrotic therapy, i.e. pirfenidone or nintedanib, is commonly used for idiopathic pulmonary fibrosis (IPF) patients awaiting lung transplantation. However, they are inferred to cause increased wound healing complications post-transplant. This study compares post-transplant outcomes in IPF patients on the basis of pre-transplant antifibrotic treatment. <h3>Methods</h3> IPF patients transplanted after January 2015 were included in a cohort study with three groups: no antifibrotic, pirfenidone, and nintedanib. Pre-specified outcomes of interest included: PGD grades immediately after transplant (T0) and on post-operative day 3 (T72), duration of mechanical ventilation, wound dehiscence, anastomosis complications, time to CLAD development, and overall survival. <h3>Results</h3> Of the 85 eligible patients, 26 received no pre-transplant antifibrotic medication, 31 received pirfenidone, and 28 received nintedanib. Fewer female patients received antifibrotic therapy, but the groups were otherwise similar with regards demographics and clinical variables (Table). There were no differences between groups in PGD status at T0 or T72, but patients who received antifibrotics pre-transplant were more likely resolve PGD between T0 and T72 than patients who did not (mean change in PGD grade: nintedanib -0.3±0.9 vs. pirfenidone -0.5±1.3 vs. no antifibrotic +0.3±1.5, p=0.026). There was a trend toward decreased time on mechanical ventilation in the patients receiving antifibrotic treatment (no-antifibrotic vs. any antifibrotic medication p=0.025, between all group p=0.07). Anastomosis stenosis was less common in the antifibrotic groups (p=0.020). No differences were observed for wound dehiscence, incidence of CLAD, or mortality. <h3>Conclusion</h3> Receiving any pre-transplant antifibrotic therapy is associated with increased resolution of PGD, shorter duration of mechanical ventilation, and decreased incidence of anastomosis stenosis.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
